Factors Determining the Success of Radiofrequency Denervation in Lumbar Facet Joint Pain: A Prospective Study

Eur Spine J. 2011 Dec;20(12):2160-5. doi: 10.1007/s00586-011-1891-6. Epub 2011 Jun 30.

Abstract

Background and aims: Radiofrequency denervation (RF) of the lumbar facet joints has been shown to be effective in well-selected patients. However, long-term success varies between studies. We evaluated the influence of selected psychosocial and constitutional factors on the outcome of RF, expressed as the duration of pain relief.

Methods: This prospective observational study included 44 patients who received RF denervations at the University Hospital of Berne. Success was defined as at least 50% pain reduction 7-21 days, 6 months and 1 year after RF therapy. The Cox-regression analysis was performed to evaluate the influence of the following factors on the duration of success: age, sex, depression, work inability and previous surgery.

Results: Complete follow-up was available for 41 patients. The success rate 7-21 days after the denervation was 76%. It decreased to 32% at 6 months and to 22% at 1 year. The median success duration was 17 weeks (95% CI 10-26). The Cox-regression analysis showed a significant shorter duration of success for patients with depression (hazard ratio [HR] 2.97, 95% CI 1.32-6.65), previous surgery (HR 2.39, 95% CI 1.10-5.21) and number of treated joints (HR 1.95 for each increase in the number of joints, 95% CI 1.14-3.33). In bivariate analyses, only depression was kept to be significant.

Conclusions: Depression seems to be related with a short duration of success. Based on these findings, a comprehensive study is warranted to evaluate whether psychosocial factors have to be considered when recruiting patients for radiofrequency denervation.

MeSH terms

  • Adult
  • Aged
  • Arthralgia / surgery*
  • Denervation / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Low Back Pain / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Prospective Studies
  • Radio Waves
  • Treatment Outcome
  • Zygapophyseal Joint / innervation*